Network Contract Manager - Northeast - Remote

Company: UnitedHealth Group
Location: Orlando
Posted on: March 20, 2023

Job Description:

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This role with UnitedHealth Group will call on your knowledge, your energy, and your commitment to making health care work more effectively for more people.Network Contract Managers develop the provider network, yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. They evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining solid business relationships and ensuring the network composition includes an appropriate distribution of provider specialties.You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

• Manage unit cost budgets, target setting, performance reporting and associated financial models
• Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
• Evaluate and negotiate contracts, reimbursement methodologies and rates in compliance with company templates, reimbursement structure standards and other key process controls
• Manage unit cost, target parameters, performance reporting and associated financial models
• Ensure that network composition includes an appropriate distribution of provider and specialties and overall recruitment and contracting to ensure network adequacy
• Work with internal contacts to implement regulatory requirements impacting provider contracts (state specific changes to state published rates, coding, new services and requirements)
• Maintain existing network contracts and any contracting events that occur during the term of the agreement while generating savings opportunities for affordability initiatives
• Coordinate high profile negotiations, build and nature trusted relationships with providers and internal state holders
• Engage facility and hospital providers and any internal resources to resolve issues related to contract administration
• Provide explanations and information to others on difficult issuesIn this role, you will need to be able to thrive in a demanding, intense, fast-paced environment. In addition, you'll be driving some complex negotiations while striving to ensure accuracy.You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
  • 2+ years of experience in a network management-related role, such as contracting or provider services
  • Experience utilizing financial models and / or financial analysis for the purpose of negotiating rates with providers or to meet other business needs
  • Experience in performing network adequacy analysis
  • Knowledge of Medicaid and/or Medicare
  • Intermediate level of knowledge of claims processing systems and guidelinesPreferred Qualifications:
    • Undergraduate degree
    • Experience in Payment Appendix and fee schedule development
    • Behavioral Health provider experience
    • Facility/Hospital contracting experience
    • Knowledge of the MA/Northeast market
    • Sound interpersonal skills, establishing rapport and working well with others
    • Sound customer service skills
    • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form othersCareers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York City, or Washington residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.-----All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Orlando , Network Contract Manager - Northeast - Remote, Executive , Orlando, Florida